What drug causes eye problems? Common culprits and ocular side effects explained

October 7, 2025 •

5 min read

According to the National Registry of Drug-Induced Ocular Side Effects, a wide array of prescription and over-the-counter medications can cause significant vision and eye health problems. Understanding which drugs can trigger these conditions is crucial for patient safety and proactive eye care, as vision changes may be a side effect of medication. Here is what drug causes eye problems and what you should know.

Quick Summary

This article explores various medications and the associated eye problems they can cause, including specific conditions like cataracts, glaucoma, and retinopathy. Key medications discussed include corticosteroids, hydroxychloroquine, and amiodarone, along with recommendations for monitoring and managing potential ocular side effects.

Key Points

Steroids Increase Risk: Long-term use of corticosteroids like prednisone significantly increases the risk of developing cataracts and glaucoma.
Plaquenil Requires Screening: Hydroxychloroquine (Plaquenil) can cause irreversible retinal damage and necessitates regular, specific eye exams for early detection.
Amiodarone Can Harm Optic Nerve: Amiodarone for heart rhythm control can cause corneal deposits and, in rare cases, optic nerve damage leading to vision loss.
Flomax Affects Cataract Surgery: Tamsulosin (Flomax) can cause Intraoperative Floppy Iris Syndrome (IFIS), a complication during cataract surgery, even after the medication is stopped.
Topamax Can Trigger Emergency: Topiramate (Topamax) can cause a dangerous spike in eye pressure known as acute angle-closure glaucoma, which requires immediate medical treatment.
ED Drugs Can Cause Tinted Vision: Medications for erectile dysfunction like sildenafil (Viagra) and tadalafil (Cialis) are known to cause temporary blue-tinted vision and light sensitivity.
Report All Vision Changes: Any new or sudden changes in vision should be reported to a doctor immediately, as some medication-induced effects can lead to permanent vision loss if untreated.

How Medications Can Impact Your Vision

Many people are aware that medications carry potential side effects, but not everyone considers the impact they can have on eye health. Medication-induced ocular problems range from mild and temporary issues, like dry eyes or blurred vision, to severe and irreversible conditions, such as retinal damage or optic neuropathy. The severity and type of side effect often depend on the specific drug, its dosage, and the duration of use.

It is important to maintain an open dialogue with both your eye care provider and your primary care physician, especially when starting a new medication. A complete list of all drugs, supplements, and vitamins you are taking can help your doctor rule out medication as a cause of vision issues and guide proactive monitoring.

Common Medications and Associated Eye Problems

Corticosteroids

Corticosteroids, such as prednisone and prednisolone, are potent anti-inflammatory drugs used to treat a wide range of conditions, including asthma, arthritis, and autoimmune disorders. Their use is a well-documented cause of several serious eye problems, especially with long-term use.

Posterior subcapsular cataracts: This is the most common ocular side effect of long-term corticosteroid use, forming within 5-10 years of regular medication intake.
Glaucoma: Corticosteroids can significantly increase intraocular pressure, leading to open-angle glaucoma. This risk is present regardless of the administration route—oral tablets, eye drops, inhalers, or skin creams. Regular eye pressure checks are vital for patients on these drugs.

Hydroxychloroquine (Plaquenil)

Hydroxychloroquine is an antimalarial drug also used to treat autoimmune diseases like lupus and rheumatoid arthritis. While effective, it can cause severe retinal damage, known as hydroxychloroquine retinopathy.

Retinal toxicity: High doses or long-term use can lead to maculopathy, which involves damage to the retina's macula, causing a loss of central vision. This damage can be irreversible.
Screening: Patients on hydroxychloroquine require regular, comprehensive eye exams, including visual field and retinal imaging tests, to detect early signs of toxicity.

Amiodarone (Cordarone)

Amiodarone is an antiarrhythmic drug used to treat heart rhythm disorders. It is known to cause several ocular side effects, from common, mild deposits to rare but severe nerve damage.

Vortex keratopathy (corneal deposits): The most common side effect, causing golden-brown deposits on the cornea in a whorl-like pattern. While generally not affecting vision, it can cause halos around lights.
Optic neuropathy: In rare cases, amiodarone can lead to optic nerve damage (optic neuropathy), which can cause vision loss.

Tamsulosin (Flomax)

Tamsulosin is an alpha-blocker primarily prescribed for benign prostatic hyperplasia (BPH) in men. Its ocular side effect becomes a critical issue during cataract surgery.

Intraoperative Floppy Iris Syndrome (IFIS): This condition causes the iris to become flaccid and billow during cataract surgery, increasing the risk of surgical complications. It is vital to inform your surgeon about past or current tamsulosin use.

Comparison Table: Key Medications and Their Ocular Side Effects


Medication Type	Common Examples	Primary Ocular Side Effects	Frequency/Monitoring
Corticosteroids	Prednisone, prednisolone	Cataracts, glaucoma (increased eye pressure)	Long-term use requires regular eye pressure and cataract checks.
Antimalarials	Hydroxychloroquine (Plaquenil)	Retinal toxicity (maculopathy)	Requires baseline and regular follow-up exams every 6-12 months.
Antiarrhythmics	Amiodarone (Cordarone)	Corneal deposits (whorl keratopathy), optic neuropathy	Regular eye exams recommended, especially with prolonged use.
Alpha-blockers	Tamsulosin (Flomax)	Intraoperative Floppy Iris Syndrome (IFIS) during cataract surgery	Must inform surgeon if currently or have previously taken this drug.
Anticonvulsants	Topiramate (Topamax)	Acute angle-closure glaucoma, increased myopia	Seek immediate medical help for symptoms like sudden eye pain or blurred vision.
Breast Cancer Drugs	Tamoxifen (Nolvadex)	Retinopathy (crystalline deposits), cataracts	Annual or more frequent screening recommended with higher doses or longer use.
Osteoporosis Drugs	Alendronate (Fosamax)	Orbital and ocular inflammation (uveitis, scleritis)	Report any eye pain, redness, or blurry vision to your doctor.
ED Drugs	Sildenafil (Viagra), Tadalafil (Cialis)	Bluish-tinted vision, light sensitivity, optic neuropathy	Seek medical advice for sudden vision changes.
Antibiotics	Ethambutol, Fluoroquinolones	Optic neuritis, retinal detachment (rare)	Report color vision changes or sudden visual disturbances.

What You Can Do to Protect Your Eyes

Tell your doctor everything: Inform all your doctors, including your eye care professional, about every medication and supplement you take.
Read labels and leaflets: Be aware of the potential side effects listed on your medication packaging.
Schedule regular eye exams: Routine comprehensive exams are critical for detecting early signs of medication-related eye damage, especially for those on high-risk medications.
Report vision changes: Report any new or worsening vision problems—such as blurred vision, dry eyes, light sensitivity, or halos—to your doctor promptly. Do not wait for your next routine eye exam. For acute symptoms like severe eye pain or sudden vision loss, seek immediate medical care.
Maintain overall health: Managing underlying conditions like diabetes and hypertension can reduce the risk of other vascular problems that may compound ocular side effects.

Conclusion

While the goal of many medications is to improve overall health, it's vital to recognize that they can have adverse effects on vision and eye health. From corticosteroids and hydroxychloroquine to heart and cancer drugs, understanding which drugs carry ocular risks is the first step toward proactive care. A collaborative approach involving your primary care physician, pharmacist, and ophthalmologist is the best strategy for balancing medical treatment with preserving your vision. Regular monitoring and prompt communication about any new visual symptoms can help mitigate risks and address potential issues before they become permanent.

An authoritative resource for further reading is the American Academy of Ophthalmology's EyeNet Magazine, which frequently publishes articles on drug-induced ocular side effects.

Frequently Asked Questions

Long-term use of corticosteroids, such as prednisone, is the most common medication-induced cause of cataracts, specifically posterior subcapsular cataracts.

Yes, several drugs can cause or worsen glaucoma. Corticosteroids can increase eye pressure (open-angle glaucoma), while drugs like topiramate and some antidepressants can cause acute angle-closure glaucoma.

The primary risk of hydroxychloroquine (Plaquenil) is retinal toxicity, which can lead to irreversible maculopathy and vision loss, especially with higher cumulative doses.

Yes, tamsulosin (Flomax) can cause Intraoperative Floppy Iris Syndrome (IFIS) during cataract surgery, which can increase the risk of complications. It is crucial to inform your surgeon about past use.

Yes, antidepressants, particularly SSRIs and tricyclic antidepressants, can cause blurred vision, dry eyes, and focusing problems. Some can also trigger glaucoma in susceptible individuals.

If you experience blue-tinted or blurred vision while taking erectile dysfunction medications like Viagra or Cialis, contact your doctor. While often temporary, it can be a sign of a more serious issue like optic neuropathy.

The reversibility of drug-induced vision damage depends on the specific medication and the severity of the side effect. While some mild effects like dry eyes may resolve, damage from retinopathy (hydroxychloroquine) or optic neuropathy (amiodarone, ethambutol) can be permanent.